Great Ormond Street Acts to End Dispute Between Surgeons

Peter Russell

January 17, 2020

An ongoing dispute between two consultants at London's Great Ormond Street Hospital for Children NHS Foundation Trust could put patient care and safety at risk, a recent report concluded.

A board paper highlighted a "fractured relationship" between two consultant urology surgeons which was having a "significant" effect on the hospital's entire consultant team.

The hospital outlined steps being taken to address the problem.

Inspection Charted 'Dysfunctional' Relationship

The board paper, dating from a meeting in November 2019, outlined the findings of an inspection by the Royal College of Surgeons (RCS).

The RCS team carried out a 2-day inspection at the end of May last year at the invitation of the Trust after concerns were raised by staff in the paediatric urology surgical unit about a "serious untoward incident".

Although the consultant team comprised excellent dedicated surgeons who looked after their patients well, "interpersonal difficulties, primarily between the two consultant paediatric urologists, seem to be causing difficulties in the operational and developmental aspects of the service", according to the paper.

"It was also of concern to the review team that there were reports of inappropriate behaviour towards support staff and consultant colleagues by a member of the consultant team," the board paper revealed.

The personality clash had been compounded by a current workload that had been "putting the consultant team under undue pressure", as well as by "frequent changes in directorate structures".

Action Plan

The Trust had made seven recommendations to improve team working and address risks to patients. These included repairing the "dysfunctional" relationship "in an appropriate time frame" between the two consultants, and training to improve the clinical leadership.

Two 'away days' were booked in December 2019 and January 2020 to help improve team leadership.

A November 2019 report on Great Ormond Street by the Care Quality Commission judged the Trust as 'good' overall but said its leadership required improvement. It said that despite having an experienced leadership team, frequent executive leadership changes had impacted on staff morale.

"The percentage of staff reporting good communication between senior management and staff was much worse than the national average," the report said, while "Trust leaders did not appear to be aware of the wide concerns raised with the inspection team by nursing staff about leadership and morale".

This week, the Trust responded to the review of its urology surgical services. It said in a statement: "We would like to reassure our patients and their families that the report did not say there were any current patient safety concerns. 

"We have taken the issues raised in the report and the recommendations extremely seriously and there has been good progress made.

"Successful mediation and the first away days have taken place and very constructive conversations have happened between all consultants, and they are now working together to shape their service to better serve the needs of their patients."

The Trust said it would update the RCS about progress made.

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